ex phys 3-11 -- exercise & diabetes

what are the blood glucose ranges for hypoglycemia, healthy populations, and hyperglycemia

hypo -- <70 mg/dL norm -- 70-99 mg/dL hyper -- >250 mg/dL with ketosis or without >300 mg/dL is a concern for individuals with Type 1 DM

what is pre-exercise CHO consumption for a pt who has a pre-exercise blood glucose level of >/=100 mg/dl and will do low int short duration ex

none

The classic symptoms of diabetes include... (3)

polyuria, polydipsia, and unexplained weight loss

diabetes diagnostic criteria: -- A1c ____%, or -- Fasting plasma glucose _____ mg/dl (7.0 mmol/L), or -- Two-hour plasma glucose _____ mg/dl (11.1 mmol/L) during an oral glucose tolerance test -- Classic symptoms of hyperglycemia or hyperglycemic crisis plus a random plasma glucose _____ mg/dl (11.1 mmol/L)

-- A1c >6.5%, or -- Fasting plasma glucose ≥126 mg/dl (7.0 mmol/L), or -- Two-hour plasma glucose ≥200 mg/dl (11.1 mmol/L) during an oral glucose tolerance test -- Classic symptoms of hyperglycemia or hyperglycemic crisis plus a random plasma glucose ≥200 mg/dl (11.1 mmol/L)

metabolic syndrome

-- Collection of interrelated cardiometabolic risk factors that are present in a given individual more frequently than may be expected with a chance combination -- Usually presence of overweight or obesity

how does exercise-induced hyperglycemia occur

-- Glucose levels significantly elevated pre-exercise secondary to extreme insulin deficiency (type 1 DM) -- During and following exercise, inadequate insulin levels unable to counteract glucogenic hormones (glucagon, epinephrine) that are released during exercise -- Results in further increase in blood glucose

what are effective prevention strategies for hypoglycemia (3)

-- Modifying insulin timing -- Reducing insulin dose -- Increasing carbohydrate consumption

what is type I diabetes caused by

-- Type 1 DM caused by autoimmune destruction of insulin-producing β cells of pancreas -- Absolute insulin deficiency and increased risk for ketoacidosis

what is type II diabetes caused by

-- Type 2 DM is caused by insulin-resistant skeletal muscle, adipose tissue, and liver combined with an insulin secretory defect -- Elevated insulin levels but insufficient to control blood glucose

Ketosis is a condition characterized by raised levels of ketone bodies in the body. Why does this occur in DM?

-- condition develops when your body can't produce enough insulin -- bc the cells cannot receive sugar for energy, the body begins to break down fat and muscle for energy -- ketones are produced when the body burns protein and fat, rather than sugar, for energy

what is the most serious problem for diabetic individuals during exercise

-- hypoglycemia (blood glucose level <70 mg/dL) -- Mainly for individuals taking insulin or oral hypoglycemic agents (e.g., sulfonylurea drugs)

concerning peripheral neuropathy in pts w DM, which of the following is NOT true: A. pts should only do low intensity, low-impact physical activity B. pts should use polyester or blend socks to keep feet dry C. pts should inspect their feet daily D. pts may have balance issues and fall risk E. pts can develop significant joint damage

A -- "moderate intensity, low-impact physical activity" should be encouraged, they don't only have to do low int

T/F: signs and symptoms of diabetes are more prevalent in type II pts than in type I pts

FALSE; Most common in those with type 1; less often or never in those with type 2 (25% of those with diabetes do not know it)

why should the RPE scale be used to assess intensity in pts w DM

HR and BP responses to exercise may be blunted due ot autonomic neuropathy, so RPE should also be used to assess exercise intensity (more accurate)

diabetes mellitus

Metabolic diseases characterized by elevated blood glucose levels (hyperglycemia) as a result of defects in insulin secretion (Type 1) and/or an inability to use insulin (Type 2)

Individuals with retinopathy are at risk for retinal detachment and vitreous hemorrhage with vigorous exercise. How can this risk be reduced?

Minimize risk by avoiding activities that dramatically elevate BP such as vigorous intensity aerobic and resistance exercise

which of the following is NOT a sign or symptom of diabetes mellitus? A. Polydipsia (excessive thirst) B. Dysuria (discomfort when urinating) C. Unexplained weight loss D. Infections and cuts that are slow to heal Blurry vision E. Fatigue

B -- "Polyuria (frequent urination)" would be a correct

autonomic neuropathy in DM may cause all of the following EXCEPT: A. chronotropic incompetence (i.e., a blunted BP response) B. foot ulcers C. attenuated VO2 kinetics D. anhydrosis

B -- foot ulcers pertain more to peripheral neuropathy

T/F: Hypoglycemia can occur up to 12 hours postexercise

TRUE

T/F: Individuals who are asymptomatic for CVD and low risk for cardiac event may not need exercise testing for light-to- moderate intensity exercise

TRUE

T/F: Number of pts w diabetes has tripled in the past 30 yrs, and estimates predict doubling in next 15 to 20 yr

TRUE

what is pre-exercise CHO consumption for a pt who has a pre-exercise blood glucose level of 100 to 180 mg/dl and will do mod int mod duration ex

15-30 g

Diabetes-related death rate is ____ times that of age-matched, nondiabetic individuals

2

what is pre-exercise CHO consumption for a pt who has a pre-exercise blood glucose level of <100 mg/dl and will do mod int mod duration ex

25-45 g

what is pre-exercise CHO consumption for a pt who has a pre-exercise blood glucose level of 100 to 180 mg/dl and will do mod int long duration ex

30-45 g

what is pre-exercise CHO consumption for a pt who has a pre-exercise blood glucose level of <100 mg/dl and will do mod int long duration ex

45 g

what is pre-exercise CHO consumption for a pt who has a pre-exercise blood glucose level of <100 mg/dl and will do low int short duration ex

5-10 g